Agenda and minutes

          The Minutes of the meeting held on 12 January 2016 having been circulated were signed as a correct record.

The minutes of the Health and Wellbeing Board meeting on 13 January 2016 were submitted to the Board for information.

Councillor M Lloyd Jones declared a Disclosable Other Interest in the following item as her husband is a Governor of Warrington and St Helens NHS Foundation Trust and Bridgewater Trust.

The Board received the Discharge from Hospital Scrutiny Review 2015-16 (appended to the report) which outlined the key findings and made a number of recommendations for consideration by Members.

The report advised that the group sought national and local evidence and undertook a range of site visits to understand best practice and the systems and issues with ensuring timely, safe and effective discharge of people from hospital.  It was noted that the contributors to the review included: Hospital Discharge Teams; the voluntary sector; Warrington and Halton Hospitals NHS FT; St Helens and Knowsley Teaching Hospitals NHST; care home support teams; NHS Halton CCG; two local GP’s and their surgeries and North West Ambulance Service.

The recommendations made by the scrutiny review were outlined in the report and Members made the following comments/points to note:

·       Mr Baker informed the Board of his own discharge experience from hospital and the problems he experienced on the day with obtaining medication and transport, which actually delayed his discharge.

·       The importance of the Voluntary Sector was recognised and they were included in the review, however it was noted that their funding sources were also being cut resulting in fewer opportunities for them to help partner agencies.

RESOLVED:  That the Board notes the contents of the Discharge from Hospital Scrutiny Review 2015-16.

Councillor M Lloyd Jones declared a Disclosable Other Interest in the following item as her husband is a Governor of Warrington and St Helens NHS Foundation Trust and Bridgewater Trust.

The Board received an update from the Strategic Director, Community and Resources, on key issues and progression of the agenda for safeguarding adults at risk of abuse in Halton.

Members were advised that the Care Act required that all Safeguarding Adults Boards were required to produce an Annual Report; this was attached at Appendix 1.  All of the key achievements and priorities the Board had been working towards over the last 12 months were summarised.  The report also set out the national and local developments on safeguarding adults at risk. 

It was reported that membership of the Halton Safeguarding Adults Board included senior representatives from all partner agencies, including Directors; Lead Clinicians and Lead Officers responsible for safeguarding adults in Halton and it was the responsibility of all to ensure that the community worked together to support and safeguard all adults who were most at risk in society.  In order to achieve this, Members were advised that the Board continued to develop and establish strong partnerships to ensure that the most vulnerable in society were safeguarded and were free from fear; harm; neglect and abuse.

Members were advised of the Safeguarding Adults Board’s four key priorities for 2014-15; these were outlined in the report and discussed.  Other areas highlighted were the Anti-slavery Network which Halton had recently joined; the Making Safeguarding Personal (MSP) evaluation; and the development of a Financial Abuse Toolkit.

The following comments were made by Members:

·       Televisions were used a lot in hospitals to raise awareness of safeguarding issues; could they not be used in other locations where communities gathered – HBC were currently working with Liverpool City Region looking at more imaginative ways of raising awareness in this way;

·       An ‘act of omission’ was clarified by example – such as unintentionally missing a dose of medication;

·       The Safeguarding Board had scheduled a development meeting on 11 March 2016;

·       The number of safeguarding referrals had risen in relation to female victims – this could be attributed to the fact that there were more females supported in the community than males;

·       The total number of referrals had risen against previous years – this could be due to a greater awareness of the need for safeguarding and the dedicated role of the Safeguarding Unit in dealing with the more complex issues;

·       What was the difference between a Domestic Violence Protection Notice (DVPN) and a Domestic Violence Protection Order (DVPO) – this would be sent to Members after the meeting;

·       An increase in the number of Deprivation of Liberty Safeguards (DoLS) nationally and locally was noted – an update would be brought to the next Board meeting.

RESOLVED:  That the Board notes the contents of the report.

The Board received an update on mental health related activity undertaken by Halton Borough Council (HBC) and NHS Halton Clinical Commissioning Group (CCG).

Members were informed that Mental Health services in Halton were under huge pressure as they were nationally, and the wait times and need for Mental Health services had risen to an all-time high.  Halton had therefore encountered significant challenges to ensure services met National standards.  Work had been undertaken to fully review all the adult services and older peoples in-patient beds in line with parity of esteem. 

It was noted that the report was completed in December 2015 and the recommendations would set the scene for the creation of a more effective, responsive service.  Further, the ongoing consultation and co-production of services would continue to help shape service provision in partnership with users of services.  The Board was advised that huge strides had been taken and the report provided an update of changes and innovation underway in the following areas or services:

·       Halton’s Wellbeing Practice;

·       Service Provision;

·       New Governance Structure;

·       Dementia Friendly Communities;

·       Admiral Nurses for Dementia;

·       5 Boroughs Footprint Review;

·       Emotional Wellbeing Services for Children;

·       The National Schools Pilot;

·       Future in Mind (FIM) and CAMHS Transformation;

·       System Resilience Funding;

·       The Mental Health Crisis Care Concordat;

·       Operation Emblem / Street Triage;

·       Liaison Psychiatry Service;

·       IAPT – Halton Psychological Therapies Service;

·       Suicide Prevention Strategy;

·       Support 4 Change;

·       Access targets for Early Intervention in Psychosis for First episode of psychosis;

·       Public Health, Mental Health Posts; and

·       Social Work for Better Mental Health

Following a request from one Member, further information on the ‘Admiral Nurses’ for Dementia would be sent to all Members via e-mail.

On behalf of the Board, the Chairman wished to convey their thanks to Councillor Dennett, the Council’s Mental Health Champion, on his work to date around the Mental Health agenda. 

RESOLVED:  That the contents of the report are noted.

The Board received the first of a two part evaluation which summarised how the Care Act had resulted in a number of changes in the way Care Management carried out its various processes. 

The document was attached to the report at Appendix 1 and discussed by Members, who commented that they were thankful for the detail and they looked forward to receiving the second report, which would help determine what difference the Care Act was actually making.

It was noted that the second more difficult part would be presented to the Board at a later date.  This would look at how these changes in health and social care were making a difference to the lives of adults with needs in Halton.  Further these two reports would provide evidence of how effective the Act had been in helping adults with a long term illness to live more fulfilling and meaningful lives while retaining their independence and active roles in their community for as long as possible. 

RESOLVED:  That the contents of the report and Appendix are noted.

The Board was presented with details of the Carers Scrutiny topic as outlined in the topic brief which was appended to the report at Appendix 1.

To provide some background Members were advised that the 2011 census found that there were over 15,000 carers in the Borough who were providing unpaid help and support to their partners and relatives.  With the introduction of the Care Act 2014, Carers were now recognised in law in the same way as those they cared for; meaning they had the right to an assessment of their needs.  As a consequence, the Act had resulted in an unprecedented focus on Carers and their own health and for the first time set out a set of national criteria to establish whether the Carer was eligible for support.

It was noted that the topic would focus on the type and quality of Carers Services provided in Halton and the associated pathways in place to support Carers’ ability to access those services.  It would examine these services and associated pathways with a view to evaluating their effectiveness in meeting the needs of the local population. 

Members agreed to accept the topic brief and it was agreed that all Members of the Board would be invited to attend the group to ensure good attendance and to give all Members the opportunity to provide their input.

RESOLVED:  That the Board

1)    Notes the contents of the report and associated Appendix; and

2)    Agrees to the formation of the Scrutiny Topic Working Group including all Members of the Board.

The Strategic Director, People and Economy, presented the performance management reports for quarter 3 of 2015-16 and requested Members to consider the progress and performance information and raise any questions or points for clarification they may have.

The report provided an overview of issues and progress against key service area objectives and milestones and performance targets, during the third quarter of 2015-16 for those service areas that fell within the remit of this Board.  These were as follows:

·       Prevention and Assessment

·       Commissioning and Complex Care (including housing operational areas); and

·       Public Health.

Members made the following points:

·       Discussion took place around the Members visits to Social Workers that occurred some years ago and a suggestion that these be reinstated.  This was clarified as being  visits to Social Workers in Childrens’ Social Care that took place following the Climbie case but had since stopped;

·       Reference made to PA 2’s direction of travel – could be explained due to some Social Workers not signing off cases as complete when in fact they were; and

·       Cancer screening facility – noted that the mobile one had moved to Warrington and would be relocated locally as soon as possible.

The Chairman wished to convey her thanks to all Members and Officers’ for their hard work and support with scrutiny groups over the past year.

RESOLVED:  That the quarter 3 priority based reports be received.